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Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review
PURPOSE: Adjuvant endocrine treatment is essential for treating luminal subtypes of breast cancer, which constitute 75% of all breast malignancies. However, the detrimental side effects of treatment make it difficult for many patients to complete the guideline-required treatment. Such non-adherence...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320891/ https://www.ncbi.nlm.nih.gov/pubmed/37403065 http://dx.doi.org/10.1186/s12885-023-11122-8 |
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author | Eliassen, Finn Magnus Blåfjelldal, Vibeke Helland, Thomas Hjorth, Cathrine Fonnesbech Hølland, Kari Lode, Lise Bertelsen, Bjørn-Erik Janssen, Emiel A. M. Mellgren, Gunnar Kvaløy, Jan Terje Søiland, Håvard Lende, Tone Hoel |
author_facet | Eliassen, Finn Magnus Blåfjelldal, Vibeke Helland, Thomas Hjorth, Cathrine Fonnesbech Hølland, Kari Lode, Lise Bertelsen, Bjørn-Erik Janssen, Emiel A. M. Mellgren, Gunnar Kvaløy, Jan Terje Søiland, Håvard Lende, Tone Hoel |
author_sort | Eliassen, Finn Magnus |
collection | PubMed |
description | PURPOSE: Adjuvant endocrine treatment is essential for treating luminal subtypes of breast cancer, which constitute 75% of all breast malignancies. However, the detrimental side effects of treatment make it difficult for many patients to complete the guideline-required treatment. Such non-adherence may jeopardize the lifesaving ability of anti-estrogen therapy. In this systematic review, we aimed to assess the consequences of non-adherence and non-persistence from available studies meeting strict statistical and clinical criteria. METHODS: A systematic literature search was performed using several databases, yielding identification of 2,026 studies. After strict selection, 14 studies were eligible for systematic review. The review included studies that examined endocrine treatment non-adherence (patients not taking treatment as prescribed) or non-persistence (patients stopping treatment prematurely), in terms of the effects on event-free survival or overall survival among women with non-metastatic breast cancer. RESULTS: We identified 10 studies measuring the effects of endocrine treatment non-adherence and non-persistence on event-free survival. Of these studies, seven showed significantly poorer survival for the non-adherent or non-persistent patient groups, with hazard ratios (HRs) ranging from 1.39 (95% CI, 1.07 to 1.53) to 2.44 (95% CI, 1.89 to 3.14). We identified nine studies measuring the effects of endocrine treatment non-adherence and non-persistence on overall survival. Of these studies, seven demonstrated significantly reduced overall survival in the groups with non-adherence and non-persistence, with HRs ranging from 1.26 (95% CI, 1.11 to 1.43) to 2.18 (95% CI, 1.99 to 2.39). CONCLUSION: The present systematic review demonstrates that non-adherence and non-persistence to endocrine treatment negatively affect event-free and overall survival. Improved follow-up, with focus on adherence and persistence, is vital for improving health outcomes among patients with non-metastatic breast cancer. |
format | Online Article Text |
id | pubmed-10320891 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103208912023-07-06 Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review Eliassen, Finn Magnus Blåfjelldal, Vibeke Helland, Thomas Hjorth, Cathrine Fonnesbech Hølland, Kari Lode, Lise Bertelsen, Bjørn-Erik Janssen, Emiel A. M. Mellgren, Gunnar Kvaløy, Jan Terje Søiland, Håvard Lende, Tone Hoel BMC Cancer Research PURPOSE: Adjuvant endocrine treatment is essential for treating luminal subtypes of breast cancer, which constitute 75% of all breast malignancies. However, the detrimental side effects of treatment make it difficult for many patients to complete the guideline-required treatment. Such non-adherence may jeopardize the lifesaving ability of anti-estrogen therapy. In this systematic review, we aimed to assess the consequences of non-adherence and non-persistence from available studies meeting strict statistical and clinical criteria. METHODS: A systematic literature search was performed using several databases, yielding identification of 2,026 studies. After strict selection, 14 studies were eligible for systematic review. The review included studies that examined endocrine treatment non-adherence (patients not taking treatment as prescribed) or non-persistence (patients stopping treatment prematurely), in terms of the effects on event-free survival or overall survival among women with non-metastatic breast cancer. RESULTS: We identified 10 studies measuring the effects of endocrine treatment non-adherence and non-persistence on event-free survival. Of these studies, seven showed significantly poorer survival for the non-adherent or non-persistent patient groups, with hazard ratios (HRs) ranging from 1.39 (95% CI, 1.07 to 1.53) to 2.44 (95% CI, 1.89 to 3.14). We identified nine studies measuring the effects of endocrine treatment non-adherence and non-persistence on overall survival. Of these studies, seven demonstrated significantly reduced overall survival in the groups with non-adherence and non-persistence, with HRs ranging from 1.26 (95% CI, 1.11 to 1.43) to 2.18 (95% CI, 1.99 to 2.39). CONCLUSION: The present systematic review demonstrates that non-adherence and non-persistence to endocrine treatment negatively affect event-free and overall survival. Improved follow-up, with focus on adherence and persistence, is vital for improving health outcomes among patients with non-metastatic breast cancer. BioMed Central 2023-07-04 /pmc/articles/PMC10320891/ /pubmed/37403065 http://dx.doi.org/10.1186/s12885-023-11122-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Eliassen, Finn Magnus Blåfjelldal, Vibeke Helland, Thomas Hjorth, Cathrine Fonnesbech Hølland, Kari Lode, Lise Bertelsen, Bjørn-Erik Janssen, Emiel A. M. Mellgren, Gunnar Kvaløy, Jan Terje Søiland, Håvard Lende, Tone Hoel Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title | Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title_full | Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title_fullStr | Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title_full_unstemmed | Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title_short | Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
title_sort | importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320891/ https://www.ncbi.nlm.nih.gov/pubmed/37403065 http://dx.doi.org/10.1186/s12885-023-11122-8 |
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